CNS Macro Trauma

Question 1

What are parenchymal cells?

Answer 1

functional tissue as opposed to supporting structures

Question 2

Prognosis for straight skull fracture

Answer 2

usually pretty good

Question 3

If someone fractures their frontal bone, were they unconscious before or after the fall?

Answer 3

before, otherwise they would have caught themselves

Question 4

If someone fractures their occipital bone, were they unconscious before or after the fall?

Answer 4

after

Question 5

Depressed skull fracture main danger

Answer 5

may damage underlying brain tissue

Question 6

Complicated fracture often found in depressed skull fractures where a chunk of bone breaks off from the skull

Answer 6

comminuted

Question 7

This type of fracture is across a skull suture

Answer 7

diastatic

Question 8

What is the complication related to a diastatic skull fracture

Answer 8

the suture widens

Question 9

What type of skull fracture may result in CSF draining from the nose?

Answer 9

basal skull fracture

Question 10

This type of skull fracture may result in a distant hematoma

Answer 10

basal skull fracture

Question 11

What is a concussion?

Answer 11

an altered state of consciousness from a head injury due to change in momentum of the head–due to stretching and snapping of the brain and not brain pushing on skull

Question 12

What is second impact syndrome?

Answer 12

having another concussion before the first one is healed

Question 13

Complication of second impact syndrome?

Answer 13

rapid brain swelling

Question 14

Pathophys of chronic traumatic encephalopathy

Answer 14

progressive degenerative disease of the brain caused by repetitive brain trauma

Question 15

What protein is most associated with chronic traumatic encephalopathy?

Answer 15

tau protein

Question 16

What are the two types of injury types of parenchymal tissue?

Answer 16

coup (same side as impact)

contrecoup (opposite side of impact)

Question 17

“Shaken baby syndrome” is a type of this parenchymal injury

Answer 17

diffuse axonal injury

Question 18

Diffuse axonal injury is due to what physiologically?

Answer 18

twisting/sheering of axons

Question 19

Epidural hematomas are caused by damage to what vessel?

Answer 19

middle meningeal artery

Question 20

What is the typical case of an epidural hematoma?

Answer 20

baseball to the head

Question 21

Radiological finding of epidural hematoma?

Answer 21

smooth contours–dura is very hard so keeps blood contained

Question 22

What vessels are damaged in a subdural hematoma?

Answer 22

cerebral veins (bridging)

Question 23

What is the typical presentation of a subdural hematoma?

Answer 23

elderly patient falls but seems okay

Question 24

Radiological findings of subdural hematoma

Answer 24

“ragged” edged

Question 25

Pathophys of subarachnoid hemorrhage

Answer 25

berry aneurysm rupture, contusion

Question 26

Typical presentation of subarachnoid hemorrhage

Answer 26

“worst headache I ever had”

Question 27

What is the new-fangled treatment of berry aneurysms?

Answer 27

coils put in through femoral vein